Degenerative Cervical Myelopathy: Towards a Personalized Approach

Area of Science:

• Neurology
• Neurosurgery
• Spinal Cord Medicine

Background:

• Degenerative cervical myelopathy (DCM) is a clinical syndrome resulting from chronic spinal cord compression.
• Pathologies include cervical spondylotic myelopathy, degenerative disc disease, and ligamentous ossification.
• DCM presents with variable symptoms like impaired dexterity, gait disturbance, and sensorimotor deficits.

Purpose of the Study:

• To review current understanding and personalized treatment approaches for DCM.
• To address knowledge gaps and controversies in DCM diagnosis and management.
• To summarize diagnostic modalities and treatment strategies for chronic spinal cord compression.

Main Methods:

• Review of basic science studies on DCM pathophysiology.
• Analysis of clinical decision-making factors.
• Evaluation of surgical and non-operative treatment strategies.
• Discussion of diagnostic modalities.

Main Results:

• Understanding of DCM pathophysiology has advanced significantly.
• Personalized treatment strategies are emerging.
• Debates persist regarding optimal clinical decision-making, intervention timing, and surgical approaches.
• Heterogeneity in DCM etiology necessitates tailored patient management.

Conclusions:

• Personalized medicine, utilizing biomarkers and tailored surgical approaches, is crucial for optimizing DCM patient outcomes.
• Further research is needed to refine management strategies for this heterogeneous patient population.
• Addressing current controversies in DCM treatment is essential for improving patient care.